Differential diagnosis of complications of esophageal atresia

Preoperative

• Aspiration pneumonia in H-type
• Long gap between atretic segments
• Tracheomalacia

Postoperative

• Anastomotic leak can develop immediately after surgery
• Stricture at anastomosis with +/- impacted food at anastomosis
• Recurrent tracheo-esophageal fistula
• Dysmotility of distal esophagus
• Distal esophageal stricture due to chronic gastroesophageal reflux

Approach to the differential diagnosis of complications of esophageal atresia (EA):
Preoperative

• Aspiration pneumonia in H-type EA is a common presentation of this form of EA
• Long gap between atretic segments can make surgical correction difficult
• Tracheomalacia can develop due to long standing compression of the trachea by the dilated proximal esophageal pouch

Postoperative

• Anastomotic leak can develop immediately after surgery
• Stricture can develop at anastomosis and worsen over time with +/- impacted food at anastomosis
• Recurrent fistula can develop any time after surgery
• Dysmotility of distal esophagus causes delayed esophageal emptying
• Distal esophageal stricture due to chronic gastroesophageal reflux